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HomeMy WebLinkAbout040-1291-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 488050 0 GENERAL INFOMAYION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Olson, Thomas I Troy, Town of 040 - 1291 -40 -000 CST BM Elev: Insp. BM Elev: M Description: Sectionlrown /Range /Map No: 4?5.5 66/\ I GS Z 24.28.20.1661 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. X72 • Septic Benchmark Y IiJ:L -L 12 " nE 4 2 ! ZOO 7Z6 ; Dosing / \ Alt. BM Ez , ^ S - `r7 Aeration � n � Bldg. Sewer Z Holding St/Ht Inlet - 7.73 y 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/� �I WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , i 1. 4 5 4 i 4+ Dt Bottom 214 '571 Dosing i 54 i '64 Header /Man. 3 Aeration Dist. Pipe Holding Bot. System !fJ_ Final Grade PUMP /SIPHON INFORMATION S 5 3 Manufacturer i errand St Cover n 7_n W,1_, GPM T' ctoo-1 Ia W Model Number TDH Lift i , Friction Loss System ead TD �, 1 Forcemain Lengt 1 ! Dia.z [ Dist. to Well A SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 4 ! -3 ' i .1K. SETBACK SYSTEM TO JPIL JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: '5 UNIT Model Number. OA u DISTRIBUTION SYSTEM; Z /Z � = 3 Header /Manifold �! Distribution x Hole Size x Hole Spacing Veto Air Intake Pipe(s) \ J L Length 1. Dia Spacing \ a " SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ? `_ �[ Bed/Trench Edges ` Topsoil Yes ! J No as No J �o f� COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 325 Lindsay R Hudson, WI 54016 (SE 1/4 SE 1/4 24 T28N R20W,) Troy Village 5th Addition Lot 133 Parcel No: 24.28.20.1661 1.) Alt BM Description = 2.) Bldg sewer length = 76 - amount of cover = IZ Plan revision Required? Yes No t 4 Use other side for additional information. J `�✓ Date Ins4pc Cart. No. SBD -6710 (R.3/97) :o ill Safety and Buildings Divi unty 201 W. Washington Ave., P.O. Box 5 7 cousin Madison, WI 53707 — 7162 itary P t Number (to be filled in by Co.) i Department of Commerce (608) 266 -3151 �d rn Sanitary Permit Application �� rate Plan LD. umber J v In accord with Comm 83.21, Wis. Adm. Code, personal information you provi e b may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address different than mailing address) L Application Information — Please Print All Information ,&JN1Y # 3 �S �, � as �, y Property Owner's Name Parcel # Lot # Block # N*4 Property Owner's Mailing Address Property Location '/4 S /., Section r City, State I Zip Code Phone Number ,�I w IL Type of ilding (check all that apply) T N; R � circle e* l j E o �aler 5 Family Dwelling - Number of Bedrooms (/ 7) Subdivision Name CSM Number ❑ Public /Commercial - Describe Use / "(f i ❑ State Owned — Describe Use ❑Ci , ❑Villa _ ty_ gXT•ewnship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 04 — 129/' J{0 - OW . /bb/ — :�. ew System El Replacement System ❑ TreatmenUHolding Tank Replacement Only ❑ Other Modification to Existing System �B• ❑ Permit Renewal ❑ Permit Revision er anae Issucd - ❑ Change of El Permit Transfer to New List Previous Permit Numb d Dt � Before Expiration I P on Plumber Owner i HIV. T ype of POWTS System: Check all that apply - - -- - -- n - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter Cl Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter XLeaching Ch be El ip Line El Gravel-less Pipe ❑Other (e lain) V. Di s t ersal /Treatment Area Information: - -a ' 1` Qw t Desigm Flow (gpd) Design Soil Application Rate( sf) Dispersal a Required (sf) Dispersal Area Proposed (sf) ation j V1. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber }'lasIic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 7U Dosing Chamber VII. Responsibility Statement 1 , the undersigned, assume respon ' ty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb r' ign e MP/MPRS Number Business Phone Number j 7/ a 3 Q, Plumber's Address U treet, City, State I Code)— - - VIII. Coun /De artment Us nl �: \pproved ❑ Disap u Sanitary Permit FIc lud es Groundwater Date Issued Issuing Agent Signature (No Stamns) Surcharge Fee) ❑ r Giv Reason for Denial IX. Conditions of p r e al — - - SYSTEM OWNER: 3� S ,t2 �2 a oflfx 1 Septic tank, effluent filter tend dispersal cell must all be serviced / maintained as per management plan provided by plumber. �` " n tt 2. All setback requirements must be maintained (* pea as per applicable code /ordinances. -� � p .� Attach complete plans (to the County only) for the system on paper not less than 81/2 xx 11 Niches in size - SD -6398 R. 01103 ( o 5�6�2 13 th ` � s 14 a k Ek s �, Page cr W Ix I i 1 i 0 - / � i -sir` 5.• �. ����� I v i Z : - -C . r titi C t; L?`hLL 2'l.✓,C�ti5tli 3' Lj`LikG__?/ /- ?Y�G1 - - :. �Qned w T �,1 9, � �+ � � O C, - -- __ '1�ii•J page of I � i t�71 its '. ,z( Arc) L�J'F'i2t >til� nature D ate 51 Gred Telephone No. Wisconsin Department Industry Hu Labor and Human n SOIL AND SITE EVALUATIO'N'REPORT Page I of 3 gel ations bons Rel Division of Safety 8 Buildings in accord with ILHR 83.05;;V1/1s`. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in sizt3. Plan must include, bet ST • c-�Z -u vK not limited to vertical and horizontal reference point (BM), direction and; %o of slope, scale or PARGEL I.D. # i2,gb l, r dimensioned, north arrow, and location and distance to nearest road. I APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REV DBY _ DATE PROPERTY OWNER: PROPERTY .0 ATIdN'` . CoU t- M T - earLp 4 w =ceu� key 5 E va /4,s14 r: PROPERTY OWNER':S MAILING ADDRESS • L T # , .BLOCK# SUM NAME OR CSM # \Z3 o I QI�Zm )�U� tJ. *t Z.3 �1 _ -I Roy U t LLftGE CITY, STATE ZIP CODE PHONE NUMBER ZJCITY ❑VILLAGE ®TOWN ' NEAREST ROAD Z k�: , "N s S 4111_/ ( ) TQ-oY L_ r"llo s" [Sc] New Construction Use [aQ Residential / Number of bedrooms AdditiQn to existing building j ] Replacement j ] Public or commercial describe Code derived daily flow b00 gpd Recommended design loading rate bed, gpd/ft • `b trench, gpd /ft Absorption area required 8 SS' bed, ft -1 SO trench, ft Maximum design loading rate • , bed, gpd /ft '� trench, gpd/ft Recommended infiltration surface elevation(s) 8 Z t3.0 C.bMi 'Tice e tf{S (as referred to site plan benchmark) Additional design / site considerations S Y,101IZ 'tv LAJ 3j1V Ltd Ohl pr} f: 3 Parent material s nv tm (3Lft tfm l 1 Flood plain elevation, if applicable 40A It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S ❑U 0S ❑U I ®S ❑U ®S ❑U I NS ❑U ❑S PQU SOIL DESCRIPTION REPORT Bod # Horizon Depth Domina Color Mottles Structure G D /ft u se I Qu. Sz. Cont Color I Texture Gr. Sz. Sh. I Consistence Bouxhy Roots :.r :ter l3eJI 1TMnch Y` 1 Fz 2 ty -6i3 t o­1 jz 316 — S) j 3 Ic s1 Ground 3 ✓,o -��y �.S�[ 3! _ S eLG►- u S9 � � - _ ,� elev. It Depth to limiting factor ? 114 Remarks: B ring # 0 -lZ 1 Gr D S °� r►1 1 — • .g 1 Ground elev. 8& -% It Depth to limiting � - factor Remarks: CST Name : - Please Print Phone: Arthur L. We erer 715 - 425 -0165 egerer So'1 Testing & Design Service -P.O. Box 74 River.Falls,WI 54022 ' Signature . q' 4 _ Z 4 7 - \ Z Date: ` CST Number: _ ��� 220254 PROPERTY OWNER (2 U1M1.eUV1 l- SOIL DESCRIPTION REPORT Page "Z-0 PARCEL W. # F E Pty) !y G E Horizon Depth Dominant Color Mottles Texture Structure GPD /ft `Z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Botxxiary Roots Bed Trerxh °} l0 `t R 3 �- G h s t t Z'F s1,1� w�'�t,. es _ , S • 6 •� Gro 3 2y -tty � -i 2 .3 - S VLG►^ U Sq w► 1 — •-1 .8 ,� 8 i Depth to I limiting factor Remarks: >`;�. >:w. '`' Z 12 Z � •S `i (Z � /' '. � cs � Gti � g old 1 C w — ^ 1 Ground 3 22 - "1 •S ' /R 3! .. Sd Cw C3Sg �,•i _ -1 elev. 88s Y ft. Depth to -- limiting factor � �z. Remarks: Bjri # stl Z`Fa -bk c4sh e t':::t E Z 1 ti =2 S\ u`i li 3l c, — s t t 2rn r c� s i.ah �, sg v" •� ^a Ground elev. ay� -4 tt. Depth to . limiting factor Remarks: 3orim # \ ... 0 -)6 z SL1�3Ly p0 ...........� >< s i 1 z�.s biz r��r c► - • S' l� b around 3 Z3-3y to�ctz 3/6 �P 8 8't. o ft. 4 3y -120 1O y2 y�� — S g, 6� � S � h1 � •1 .8 r )epth to imiling actor Remarks: _ i� PLOT P LAN Pa 3 of 3 Y SCALE 1 "= 5O ' Lot- - .BSS.sy' o,v mum P+pE I a� \u►� - o N s ��1- �1 _87�. Z3 o►� a auD � 5 y L- s L DL o f Z4" Oi%VK s�o 6 S tT k — WT 1Z-3 �'\����5 ten. &8 ► t`RPc�. oY m -Q SE lU - 14 E _► �f' _ L� ? - ZS ' �-IZUM .: l 9- Wt*Ll SO 11-j oTlzz . ' ` 1 w S7ftLt�z -1wl: _.w /_ c ._C Ppsf C f`1 �l 9- Za7 -12 Z J Z z.zoZSy 015 ) 425 -0169 CST Signature Date Signed Telephone No. CST # 01/12/2006 11:22 2350867 HUUERb HLUMUNU, 1NG rr�at eel ROGLRS PLUMBING, INC. E4457 HIGHWAY 12 MENOMONIE, WI 54751 PHONE: (715) 235 -1132 FAX: (715) 235 -0867 FAX COVER, SHEET Date: Wednesday, January 11, 2006 TO: Kevin Grabau Company: St. Croix County ,Zoning Fax #: 715 -386 -4686 Re: Olson sewer Pages: 3 (including cover sheet) Comments: Kevin, Here is the missing paper work for that Olson sewer design. From: Y - Z" " , 01/12/2006 11:22 2350867 ROGERS PLUMBING, INC PAGE 03 COK3.1NATJON SEPTIC TANK /PUMP CHAMBER (No Scale) Approved Locking Manhole Cover With Warning Label Attached q A Weatherpror)f Approved Warning Label—­­ Junction Box V y nt C L %P%K 4 0-n, T A i n ai �inal Grade :4" Mini 4" Mini Quick i 1 ?. i" i o i Pum Di ct w ee;; . Baffle I r ------------ p� n roved Joint P, I i 7'1 A] ,;Mi 3" Alarm 64 B B Appr d Joint Soil On 6 1 W/4 0 V_ C Exte nq 3' -4 off Onto I i(5 SC) Co Block 3" of Beddinq Under Tank—/ Ilump and Alarm Are On Separate Circuits !ank Manufacturer": !drik size-Septic/pump: /J'50_/ _7115 Gal Ions Alarm Manufacturer: , Number- Capacities. A inches or ons Ions Switch Type: + C inches or 34.2!1 Pump Manufacturer: + C f i nches or ., 2, b Ilons Model Number: + D /:4 inches or /Cv;. Ions Minimum Dis Total . _6L2inches Ilons Y �' �rtical Difference Botween Pump Off And Distribution Pipe Feet V, — I 11iflikan Requi red Supply Pressure' c eet 1 70 eet of Force Main x _ Factor/100 Feet: : eet Inch Diameter Force Main ... ....... Total Dynamic Head:. /0.11, !et P ROJE("V: (915-ow e aq ofj 01/1212006 11:22 2350867 ROGERS PLUMBING, INC PAGE 02 TDH Calculations TOTAL DYNAMIC HEAD CALCULATIONS Gravity or Pressure Dosed Systems OLSON Owner's Name 1/4/06 Review Date X G Gravity Dosed, or gpd Design Wastewater Flo X Pressure Dosed ft Total Combined Lateral igth Y or N Y Forcemain Drainback j in Lateral Diameter 30 ft Forcemain Length 2 in Forcemain Diameter 15 gpm System Flow Rate �— T 10-00 ft Minimum Design Head �C ft VerticalLift . ft Forcemain Friction Loss , 10,16 ft Total Dynamic Head 1.53 ft/sec Forcemain Effluent Velocity Forcemain velocity problem� Choose Pump That Discharges At Least: 15.00 gpm at �( 10.16 1 feetTDH Maximum dose volume is >20% of design wastewater flow gal Maximum Dose 0.0 gal 5x Lateral Void Volume 4.94 gal Forcemain Drainback 4,90 gal Forcemain Drainback #VaLUE! gal Maximum Dose Volume 4.9 gal Minimum Dose Volume Version 4,1 ( 07/03) 1 W TOTAL DYNAMIC HEAD /FLOW bi W w w — PER MIN UTE PUMP PE F R 0 NCE CURVE MODE 53/5 /57/59 EFFLUENT AND DEWATERING I 20 — MODEL 53/55/57/59 Feet Meters Gal. Liters 5 1.5 43 163 ��. - - -- - 10 -- 10 34 129 - - - -- - 15 4.6 - - 19 72 i l ? j 009897 Shut -off Head: 19.25 ft.(5.9m) 5 -- —� -- - - -- - 37 ;rte 63/16 4 5l8 -- /-! / 1 11 -11 112 NPT 10 20 30 40 50 37'8 GALLONS LITERS I 0 80 160 FLOW PER MINUTE ` ` < a i Variable level float switches available. — Variable level long cycle systems available: ,. Available with special cord lengths of 15', 25', 35' and 50'. Alarm systems available. Duplex systems available. A 1 3 M2 I � - sr.,_,. M 53155 &ev15 Vo lts 15 rphl g odoe C A Simplex Duplex O YA t in Y 2. Single e I float operated able level float switch, no or double contr able level 97 1 _ - _ piggyback piggyback N53/55 & N5 7159 115 ! 1 Non 9 7 _ 2 3 or 4 & 5 Y _ Y — float switch. Refer to FM0477, BN 53 115 ! 1 A uto 9 7 Y Y 3. Mechanical alternator "M -Pak" 10 -0072 or 10 -0075. 6N_ 57 x_115 _ Auto 97 N Y -- -- — 4. See FM0712 for correct model of Electrical Alternator. bE53157 230 -- I 1 _ Auto 4 8 _ Y_ _ Y _ D53155 & D57i59 l 230 1 1 ` Auto 4.8 1 — Y Y 5. Variable level control switch 10 -0225 used as a control activator, with Elecirical —— — — - - -. E53i55 & E57159 2323 1 j No n_ I�4 8 �— 2 3 o r 4 & 5 Y y Alternator (3) or (4) float system. Single piggyback switch included. ' D CAUTION For information on additional Zoeller products referto catalog on Piggyback Variable Level Float Switches, FPv10477; i(",I I(JA JkA _I, I 1ci wiring shuulci Inc dune oy Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump /Sewage Basins, FM0487; and Single Phase �:J i c; Shuuld ue WhIDIJea 1 HU Simplex Pump ControlfAlarm Systems, FM0732. ;ni id: I b�c��l -:�_ia (idrr , _,nrl ?hr, Occupa'nonal 11i'ly 11111 N_ For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOX 16347 Louisville. KY 40256 -0347 Manufacturers of.. SHIP TO: 3649 Cane Run Road ® Louisville. KY 40211 -1961 QjJQL2TYPZIM. /iNCE 939 http:/iwww.zoeller.com (502) 7 FAX (502) 78403624 926- PUMP © Copyright 2004 Zoeller Co. All rights reserved. Chamber SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Soil Absorption Systems Thomas Olson , Owner's Name 1/4/06 1 Review Date � Y or N Highly Pretreated Effluent 3 ft Suitable Soil Below System 12 in Chamber /Unit Height 8 ft Maximum Bury Depth 3 Ezflow EZ1203HP & EZ102H 600 gpd Estimated Daily Peak Flow 0.70 gpd /ft` In -situ Wastewater Infiltration Rate 857.14 ft Chamber /Unit Area 50.00 EISA ft / Unit 18 # of Chambers /Units 880.00 ft Proposed SAS Elevation 26.50 Bottom Area ft / Unit Soil Surface Acceptable Finished Gra EL 4 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 882.00 889.00 881.70 124 874.37 $76.7 Yes Fill required l�Jn as g 880.80 116 874.13 879.80 No Fill required 1.4 A c 888.00 114 881.50 887.00 No la a D 885.40 122 878.23 884.40 Yes 881.00 120 874.00 8VAlT Yes Fill required 6 epth of suitable soil required below the infiltrative surface for treatment. 2. ota g V ) l height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. !)� 4. Based on chosen system elevation, and chamber height. Top of chamber is finished grade may be required to meet minimum or maximum code standards. Version 4.0 04/03 POWTS OWNER'S MANUAL MANAGEMENT PLAN 1 1'l TION SYSTEM SPECIFICATIONS S �' Septic Tank Capacity o gar i . Septic Tank Manufacturer 1 { r, �N P TERS Effluent Filter Manufacturer 0 I i gpd/bedroom (z - � ❑ NA Efflue Filter Model _ 0 ,i cis Ci of Bed rooms 100 A r of Commercial Units NA Pump Tank Capacity o� gal [3 r ced flow (average)* Pump Tank Manufacturer � ❑ yvo g al/day anufacturer 103i n flow (peak), estimated x 1.5* � gal/day p 7 ` ° '� 'L'� ❑ Pump Model / 5 i��£.alication Rate gal/day f - T' Pretreatment Unit ❑ iN . zllu s:it/Et'fluent Quality (NA❑) Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (F li ) < m /L 30 m L Mechanical Aeration Wetland sKX.'iic.inicalOx en Demand ODs � ❑ ❑ tland Oxygen (B ODs) < 220 mg/L r Disinfection ❑Other: Total al Suspended Solids ('1 SS) Manufacturer: Model: 250 rng/L e - Dis sal Cell (s) { . ted Effluent Quality ❑ Monthly Average * ** P ' ( ) i3�rn� cal Oxygen Demand (BODs) 1 ❑ In- ground (gravity) M In- ground (pressur!:. Total Suspended Solids (TSS) 30 mgiL ' ❑ At -grade M Mound 5 30 mg /L ❑ Drip -line [3 Oth cuZ Colirorin (geometric mean) -- <_10 , cfu /100m1 beaching Chamber Manufactarer i „ taxi-m um Ef fluent Particle Size 1/8 inch diameter Model F2 1 7v 3 Approval Stipulation ti'astewater Flow Verification on and calculations: Soil Application Rate • 7 gp d/fi 2 Area Req. `iic.-r diwi bedroom based) I Absorption Area Credit per unit Minimum Number of Chambers % f ❑ Aggregate Design Flow/Loading Rate = it , , .i• \' 1a.-s typical for domestic (non - commercial wastewater { Materials: all materials must comply with WI Adm. Cocl �,i id septic tank effluent. COMM84 and be installed per manufacturers specificati- ,� i 1..hacs P ty pical for retreated wastewater. and approval letters. P DESIGN C i "Wisconsin At -grade Soil Absorption System, Siting, Design & Constriction Manual” (Converse et.al.1990) C` "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. ublication 15.22 17 - "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 - I "resign of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manua. 7nsite Wastewater Treatment and Disposal Systems ". EPA 625/1••80 - 012 October 1980 `.3D - 10570 -P "At- Grade tIZ.6f99j At Grade Com orient Manual Using Pressure Distribution" P o !7 SBD - 10567 -P (8.6/99) "In Ground Absorption Component Manual" Ci SBD - 10705 -P (N.01 101) "In Ground Soil Absorption Component Manual" Version 2.0 r_--1 SBD - 10628 -P (N.6199) "Recirculating Sand Filter System Component Manual" [­ SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" l_ -', SBD - 10572 -P (8.6/99) "Mound Component Manual" f-I. SBD - 10691 -P (N.01 101) "Mound Component Manual" Version 2.0 0 S +3D - 10595 -P (R.6199) "Single Pass Sand Filter Component Manual C] IQ BD - 10657 -P (8.6/99) "Drip -line Effluent Disposal Component Manual" C` >> SBD - 10573 -P (R 6/99) "Pressure Distribution Component Manual" r� SBD - 10706 -P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 t_ i Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT 0filNTENANCE MONITORING SCHEDULE - Service Event Servic Frequency inspect condition of tank(s) At least once every 3 ❑ months e ar(s) (Maximum 3 yrs _ Pump out contents oftank(s) When combined slud and scum equals one -third 1 /3) of tank volume suspect dispersal cell(s) At least once every ❑ months QMyear(s) (Maximum 3 - jean effluent filter At least once every ❑ months ear(s) _ -T - bispect pump, pump controls & alarm At least once every 3 [I months ear(s) ❑ NA.. j{ ush laterals and pressure test At least once every Cl months ear(s) ❑ NA 1 yes At least once every Cl months ❑ year(s) j3f f' At least once every Cl months ❑ year(s) ?A ` ' th i..c'w construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemic�t .,;. impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of J., is) removed by a septage servicing operator prior to use. start up shall not occur when soil conditions are frozen at the infiltrative surface. Rr ` i ON x "operty owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The u _ - ,- ,i i( I i quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water -savii ipyh and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water o criers, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground s , a .,. ' .-• . encytr possible. Note: this does not include laundry waste, showers, dishwater, etc. s system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetab l.% is and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the ia: r that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkin= ( cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, usini octants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your P: . ,,ind contaminate your drinking water supply. ti in a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system comp:_ ­0113 uaction of snow over the dispersal unit may cause it to freeze: up. rives shall be operated in the following manner: ruls Alarms should be tested on a regular basis by the home owner, if an alarm sounds, contact an individual licensed to servic.- "OWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved utnti , ; )..oblems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. N IECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, iv;; Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedu.!: °:` ptic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify an: or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to tt.c- surface. Access openings used for service or assessment shalt be sealed and/or locked upon completion of service. A defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effec locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (iii) or more of the tank volume, the entire of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NISI 13, Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. U 'Pullip Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check inus'; made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of The f: i I� 1 Any service needs or repairs shall be promptly taken care o£ Any Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the re authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or irnpend;,­ hydraulic failure necessitating more frequent monitoring. ij0, tit- Grade, hi- Ground Pressure " inspection-shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for an-, vidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulate ' authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic fal iecessitatiing more frequent monitoring. 'Ile pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The later-J �;oould be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to �nsare that equal distribution of effluent is occurring to promote the longevity of the system. w' arts I' r maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administu a � 4ioONMENT r .e POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is p G ; > and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and r. e?noveci or their covers removed and the void space filled soil, gravel or other inert solid material. ENC:Y PLAN i. fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant jci:z�lernt system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systcr, P rP h!ne replacement area should be protected from disturbance sand compaction and should not be infringed upon b require, P g P Y uire q s from existing d proposed structure lot lines and wells. Failure to protect the re •t g p p p placement area will result In �,.. nc< ed for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will suit in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must Ucm PY I with the rules in effect at that time. I A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technolog-, bolding tank may be installed as a last resort to replace the failed POW TS. 1 -.-, 'f-ie site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluat o must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installer- as a last resort to replace the failed POWTS. P.dound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltra , surface. Reconstructions of such systems must comply with the riles in effect at that tired. 3 WNfNG >> =?x'- i'IC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT r4`t: >EN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. VI xTI -T NIAY RESULT., RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR �4*OSS1BLE. I'DI`.IONAL COMMENTS `t )W ;S I NSTALLER ' OWTS MAINTAINER _ Name on ho le Phone 1' P 'ACE SERVICING OPERATOR (Pu mper) L REGULATORY_ AUTH _ : gency �T� /K Cept ?L4V, /AJ4 `� Zjtj /" _ Y one 44 S , VWVDA'i'.y\EHTOWTS OWNER'S NI9,NUAL.doc _.._.Dec. 29. 2005- 4:39PM Date:fl/21/2004Time:3:500�PM A ll ��No. i�`ll��., r e2 From: T0: TONY - - ' ST CROIX COUNW SEPTIC TANK MAINTENANCE AORSSWNT AND OWNERSHIP (ERTIRCAMON FORM owns/Buyer � v1 p e,(�rt1 a vt .55 Pro Address �;b � 1 � �`� C� ��� � ' ✓� perty ��tion �d from Plsooioe Dopscmeat cat seN ooatRwAioa) L- `Ics✓l PwA Wmdfl*W= Numbs .. Pcopmy Loteatlos S F V. Ste. v Sac. -=-�+ T� " Tomt d .e- s � ��f'� Lot ✓ . Sabdirtsion � y t � . Cwwwd Barra bup II - , volume P&P S Wa rnty Doe& & 1 1 2 'W4, _ volume jL___, Pap At spa bom p yet t/ Lot Inca t� y es 0. so a+ te ad�eoroea[ POmt���swltbid s.t ad de surge"* every am IMl at Msee, � podt�r a used pmaper. W1tu yaa pat ials dM '' e�adtie ias�tiaa etde aepgie Imt a a meatasat s� !a dr watib diepael � . t otsd6aaos ior� s� �!' de °""�'Od b a ng Vi JS g % W W 41p= M tadmit b Sc ?+offs Depaaomt t diea.ate�aMe�MOrd sJ"t �, pissbaaravorodpaa4er t i Mdgem Awl"a;,a,r'rlptq+i�Cd, ,,be.epsae,alt4las�ss atdiod tik tdD asdeatipsdttaoe Bead dre above aigatreade � +P� is eseis�ia dos pda�ts ae� �� s�'ri� ie.d•+uk • atisi� 1,os4 s X67 � of Cbaa■ooe sd tibe Dt�t+attt a�ttishet�essetoes. sass d�esoonit� Osdtkr� ��7� aepr�s ofelas�Lotbes esiadoed mast be peepttleitaed sebsed b {ba St Qtobc C+sasey T�arYts 06°a� ]0 � �lde dsas far at�iratiosdt� AMA DATE j( dds h m Ne t= M de{e bat a(ary (ow')1awwledea I (wa) a' (�� OMO d DATE . dE deersiei abote. by virao d a deed reootidr4 is tteRWec d Dade Omer. 1�E Q AfruCANT �q >i�itaMOgoa dMR M o + aver atsok m die =Auy pmt b ft to a lb by fee Ti= f DWw=wL" `"` � " Iadaie to Ibis appliattiM a dtwgW waaaagr &w ilt♦m tba Reptiles d Deeds oMw a a07 of the oerd6ed sarey arty J e AOe li made in toe trwow doo0 l� 2 1) 3 1 P 1 9 9 8 z KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIX Co., WI oocuunant Number RECEIVED FOR RECORD -,z_ -- 11/21/2005 09:45AN This Deed, made between WARRANTY DEED I� Troy Developtllent Corporation, a Minnesota Corporation EXERT f �f Grantor, REC FEE: 11.00 and Thams J. 01 son TRANSFFEE. 629.70 COPY �I CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following 1� de estate In `Mt • f=rQiX County, State of Wlsconstn: iot 133 of the Plat of Troy Village 5th in the Torn of Troy, St. Croix County, Name and Retvn Address �i Wisconsin. li J. 01 +� •1 ay East Sub to Declarations of Covenants, Conditions and ti s, NN Restrictions for Troy Village, recorded in Vol. 1241, Page 256, as Doc. No. 559964, and the Declaration of Golf Course, Covenants, Conditions and Easements, recorded in Vol. 1241, Page 301, as Doc. No. 559969, 040- 1291 - 40-000 . all as appearing in the office of the Register of Deeds - for St. Croix County, Wisconsin, and such other Paroel IdardtGoOlon Number ' easements, restrictions and reservations of record, This is not homestead property� or in use, and the "Buyer" obligations contained in (is) (is not) the Purchase Agreement for this lot. ,4 ti i t 1 Ij i, 11 i Exceptions to warranties: (� 1, Dated this 18th day of Noyenber 2 (SEAL) . /Richard Haluptzok, Vice - Presid Troy Development Corporation (SEAL) r ► i# AUTHENTICATION ACKNOWLEDGMENT 11 a Minnesota ; Signatures) State of VW-scosl**". ss. Anoka � authenticated this day of Personally name before me this �1a& day of NOVfJ1�eY the above tamed c ar Ha uptzok, Vice - President Troy Devel Corporation TITLB: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing I authorized by 5706.06, Ms. Stats.) instnunent and acknowledge the satna. f� -' TH131N8TRUMEPfr WAS DRAFTED BY Gza i �! TROY DEVEWPMENT CORPORATION + I , Carrie A. Albrecht Notary Public, State ef- Wi.aamhi -Anoka County, Minn. :! Charles S. Cook, President My commission is permanent. Or not, state expiration date: I! (Signatures may be authenticated or acknowledged. Both are not January 31 2010 ) it necessary) • N— of s /n tit must be a tad below their e , F+�ns �anw r mar vw d prb, ramtw.. ► STATR BAR OF WISCONSIN WleoornN i•sar Elvllt Ca, No. WARRANTY OERO FORM Na,. 2 - 19a8 MMrrlkw, W4. CAIMA. NOrM1f !'NRIC � MNNE80TA lrir Oe11111i1b11 Eapls Jan. 31.2010 s� � 00 L � 36 130 of 1.406 ACRES , 0p \ 61,224 S.F. �►�•�ti OUTL O T 2-, N 86000 oo" E �� TRO Y VILLA GE_ QQ � BENCH MARK: TOP OF 2 1 /2 " W s IRON PIPE _ �O 210.00' ELEVATION= 859.85 ,131 o Z P �� %� qC� O N i O�pQ JQ' ��` • F �. Q �� ,�Oc o p. 00I ° l23 00' E d) ` F\ � 23 54 . 7 3• h• �O, c' w _ �• 0 • 132 o ��• 1.047 ACRES, 0 N \ .�• o 133 134 45,604 S.F. _ O \ ` ° cw 1 44,901 S FS 1.006 ACRE`. 0 43,812 S.F. O 0) O 258 r^ 90 .82' '0 S 40" E 349.38' ro mod, ��- ��' \� o 349.38' 0. N 88 0 57' 40" W • Q.�`sa,. � i OUTLOT 16 7.032 ACRES 306,327 S.F. SOt SE 71.66' ;. C3 °0 428.34' W� - 88 0 57' 16" W 500.00' N 88 0 57' 1 t